Almutairi Waleed, Al-Dahman Yousef, Alnassar Faisal, Albalawi Olayan
Department of Endodontics, College of Dentistry, Qassim University, Qassim, P. O. Box: 1162, Saudi Arabia.
Department of Endodontics, Eastern Riyadh Dental Center, Second Health Cluster in Riyadh, Ministry of Health, Riyadh, Saudi Arabia.
Clin Oral Investig. 2022 Apr;26(4):3333-3342. doi: 10.1007/s00784-021-04333-5. Epub 2022 Mar 3.
Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)] or antibiotics.
We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case-control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type.
Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15-0.45,[Formula: see text]=92.6%), 46.5% with Ca(OH) vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH) group (46.5%, 95% CI: 0.17-0.68,[Formula: see text]%) than in the antibiotic group (10%, 95% CI: - 0.04-0.43,[Formula: see text]%).
Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH) paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification.
This study highlights the significant association between complete calcification and Ca(OH) paste.
钙化是牙髓再生治疗（RET）后牙髓病病例中的常见表现。我们旨在确定RET后根管内钙化的发生率，并比较使用氢氧化钙[Ca(OH)]或抗生素进行RET时根管内钙化的结果。
我们在PubMed、科学网、ProQuest学位论文数据库和Scopus数据库中检索了截至2020年5月发表的英文临床、横断面、病例对照和队列RET研究，这些研究报告了RET后出现钙化的病例。使用随机试验的Cochrane偏倚风险工具和非随机干预研究中的偏倚风险进行偏倚评估。采用加权逆方差法的随机效应模型对根管内药物进行总体和单独的荟萃分析。根据钙化类型进行亚组分析。
纳入8项研究。RET后根管内钙化的总体发生率为30.7%（95%置信区间[CI]：0.15 - 0.45，[公式：见正文] = 92.6%），使用Ca(OH)时为46.5%，而使用基于抗生素的根管内药物时为25.8%。完全钙化结果的亚组分析显示，Ca(OH)组的完全钙化发生率（46.5%，95% CI：0.17 - 0.68，[公式：见正文]%）高于抗生素组（10%，95% CI： - 0.04 - 0.43，[公式：见正文]%）。
基于纳入的研究，现有证据表明完全钙化与作为根管内药物的Ca(OH)糊剂之间存在统计学上的显著关联。其他促成因素，如血凝块形成和随访时间，在根管内钙化形成中可能也起着重要作用。
本研究突出了完全钙化与Ca(OH)糊剂之间的显著关联。
